Varicose Veins vs. Spider Veins

What is the difference between varicose veins and spider veins?  Are they the same thing? Spider veins and varicose veins both refer to dysfunctional, dilated leg veins but the main difference is the size of the veins. Spider veins are small, thread-like veins at the surface of the skin. They often appear in clusters or can have a ‘starburst’ or spider-like pattern. Varicose veins, are larger veins that appear swollen, twisted cordlike veins that ‘bulge’ at the surface.

Both spider veins and varicose veins can cause pain and other symptoms like burning, aching and throbbing. Both can be treated without surgery.

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This image describes the difference between spider veins and varicose veins. Both are manifestations of unhealthy veins. Spider veins are essentially, tiny varicose veins.

How is Venous Reflux Diagnosed?


Venous duplex imaging uses ultrasound waves to create pictures.  La Jolla Vein Care utilizes state-of-the-art ultrasound scanners to image the veins beneath the surface of the skin, not visible to the naked eye. Duplex ultrasound imaging can identify if the vein is healthy, or if it is refluxing, or if there are any blood clots in the vein.

Duplex ultrasound combines Doppler flow information and conventional imaging information, sometimes called B-mode, to allow physicians to see the structure of your blood vessels. Duplex ultrasound shows how blood is flowing through your vessels and measures the speed of the flow of blood. It can also be useful to estimate the diameter of a blood vessel as well as the amount of obstruction, if any, in the blood vessel.  Conventional ultrasound uses painless sound waves higher than the human ear can detect that bounce off of blood vessels. A computer converts the sound waves into two-dimensional, black and white moving pictures called B-mode images.

Doppler ultrasound measures how sound waves reflect off of moving objects. A wand bounces short bursts of sound waves off of red blood cells and sends the information to a computer. When performing duplex ultrasound, your ultrasound technologist or physician uses the two forms of ultrasound together. The conventional ultrasound shows the structure of your blood vessels and the Doppler ultrasound shows the movement of your red blood cells through the vessels. Duplex ultrasound produces images that can be color coded to show physicians where your blood flow is severely blocked as well as the speed and direction of blood flow.  Venous reflux refers to back flow of blood across dysfunctional vein valves.  The direction of blood flow is detected by ultrasound.  This is measured in seconds.


La Jolla Vein Care image that shows reflux in the great saphenous vein. Duplex ultrasound combines Doppler flow information and conventional imaging information, sometimes called B-mode, to allow physicians to see the structure of your blood vessels.

Foam Treatment of Venous Malformations

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Venous malformation of the lateral leg before treatment. Venous malformations appear like abnormally dilated bluish vessels near the surface of the skin. They appear in clusters and look different than typical varicose veins. They often appear during childhood, as opposed to varicose veins.

Venous malformations comprise either superficial or deep veins that are abnormally formed and dilated.  Although they usually are present at birth, they may not be seen until years later into adolescence or even adulthood. The natural history of a venous malformation is slow, steady enlargement. However, events such as surgery, trauma, infection, or hormonal changes associated with puberty, pregnancy or menopause may cause rapid expansion.

At La Jolla Vein Care, we frequently evaluate and treat superficial venous malformations of the legs. Prior to treatment, it is important to have thorough diagnostic imaging, such as an ultrasound examination to ensure an accurate diagnosis of a pure venous malformation.  If an arterial connection (arterial venous malformation) is suspected on ultrasound evaluation, further imaging with CT or MR arteriogram may be necessary. Venous malformations can also occur in other syndromes, such as Klippel -Trenaunay syndrome and may involve the abnormal development of the deep veins.

Pure venous malformations can be treated without surgery. Foam sclerotherapy is a common treatment type.  Foam sclerotherapy uses a technique to inject a foamed sclerosing solution into the cluster of varicose veins, which will cause them to collapse and eventually dissolve.


Venous malformation after treatment with ultrasound guided foam sclerotherapy at La Jolla Vein Care. Treatment can reduce the symptoms associated with venous malformations such as leg pain, aching and throbbing.

8 Warning Signs of Vein Disease: #4 Swollen Ankles


Ankle swelling related to varicose veins and venous insufficiency may be subtle, leaving indentations from socks.

Swollen Ankles at Night

Thick, swollen ankles are signs that blood or other fluid is congested in the leg and / or leg veins. Over time, damaged vein walls can become even more stretched out and permeable, allowing fluid and protein to filter from the veins into surrounding leg tissue. When you lie down at night, the pressure from gravity is equalized across your leg. Usually, vein related swelling (venous edema) becomes apparent later in the day or worse throughout the day and improved with leg elevation or overnight during sleep.  Often in the morning, there may be no swelling. But, as the day progresses gravity causes poo

ling of blood around the ankle in incompetent veins. Venous insufficiency is one of the most common causes of ankle swelling that worsens throughout the day. Sometimes, the swelling can be subtle, leaving indentations from sock lines. Or, it may cause the skin to feel firm, shiny, or puffy by the end of the day.

If you have swelling, you should discuss it with your health care provider. Venous insufficiency can be diagnosed with a venous duplex sonogram, which is a non-invasive study of the leg veins.

8 Warning Signs of Vein Disease: #3 Open Sores or Ulcers on the Lower Leg


Venous leg ulcers are the result of chronic venous insufficiency and venous hypertension, which causes the skin to break down.

When chronic venous insufficiency reaches its most serious point, ulcers may appear on the lower leg. These open ulcers are the result of blood leaking into the leg tissue and damaging the skin. Open sores need to be treated by a doctor immediately.

New Product: The Scat Belt Becoming a Favorite Exercise Companion

Exercise is an important component of good vein health.  Exercise empties the veins of the legs and is beneficial to the cardiovascular system.  As a result, regular exercise, even a walking routine is beneficial to the leg veins and can help reduce leg symptoms.  A new product was developed that keeps you safe during outdoor exercise, such as going on evening walks or hiking in areas that are less populated. The Scat Urban Belt, allows you to carry pepper spray, a super loud alarm, a smarthphone and even a bottle of water!  For more information, go to


The SCAT URBAN Belt is lightweight, comfortable and provides peace of mind because you’re prepared and protected. The Urban comes in three great colors and two adjustable sizes for optimal fit.

Access pepper spray, an ear-piercing personal alarm and smartphone within seconds – also carry a bottle of water.

What are Vein Valves?


In healthy veins, the valves close after the blood flows towards the heart, preventing back flow.
When veins become dilated, the valves cannot close properly, allowing blood to flow back towards the ankle.

Vein valves play a critical role in helping blood flow through the veins back to the heart. Like swinging doors, valves open to allow blood to flow toward the heart and flap closed again to prevent the flow of blood back down the legs. If the veins become dilated, the flap-like valves cannot completely close, making them incapable of preventing the back flow of blood. This ‘back flow’ of blood through dysfunctional valves is called venous reflux or venous insufficiency.

Society for Vascular Medicine Meeting To Be Held in La Jolla

The Society for Vascular Medicine’s 25th Anniversary and Scientific Sessions 2014 are going to be held in La Jolla this week. La Jolla Vein Care’s Dr. Bunke was asked to speak on venous topics.  The keynote speaker will be Dr. Jonathan Woodson, MD, U.S. Department of Defense, Assistant Secretary of Defense (Health Affairs). There will be several scientific topics and research discussed over several.  Some of the topics include:

Venous disease

Lymphatic disease

Anticoagulants, thrombolytic therapy

PAD/endovascular therapy
Carotid arterial disease/endovascular therapy

Management of the non-healing wound in venous disease
Management of the diabetic wound
What do the guidelines recommend?

 Sclerotherapy, laser, endovenous approaches, liquid sclerotherapy
Foam sclerotherapy
Endovenous laser and instruction for access
Endovenous RF and instruction for access
Chronic Venous Disease
Epidemiology and pathophysiology including molecular insights into venous ulcer formation
Medical management: Compression therapy, novel herbal agents (horse chestnut and others)
Endovascular therapy: Ablation, radiofrequency, laser (superficial vs. deep incompetency)
Treatment of chronic venous occlusions svmlogo

How Do Varicose Veins Develop?


This image demonstrates how varicose veins develop.

Your veins have one-way valves that help keep blood flowing toward your heart. If the valves are weak or damaged, blood can back up and pool in your veins. This causes the veins to swell, which can lead to varicose veins.